Everyone has the occasional night when sleep just won’t come. But if lack of sleep is affecting you during the day as well as at night, and improving your sleep habits hasn’t helped, it might be time to see a doctor, advises Nathaniel F. Watson, M.D., co-director of the UW Medicine Sleep Center in Seattle, Washington. “An insomnia disorder involves not only nighttime sleep complaints, but also daytime symptoms such as fatigue, sleepiness, memory problems, impaired job performance, and moodiness.”
There has been a great deal of research into sleep in recent years, and many new techniques and treatments are now available. Working with your doctor, you should be able to figure out what’s keeping you from getting deep and restorative sleep.
It’s all in the details
Your visit to a sleep specialist will probably be a little different from visits to other doctors. Your sleep doctor will take the usual medical history—asking about any other health issues you may have and what illnesses may run in your family—but will also want to know a lot about your daily life.
“I usually ask what a typical 24-hour period is like—not just at night. I’ll want to know when and what you eat, when and how much you exercise, what your daily routine is like,” says Gopal Allada, M.D., a sleep specialist and an associate professor at Oregon Health & Science University School of Medicine in Portland.
Obtaining complete information about your habits and routines will help your doctor figure out why you’re having sleep issues. Some doctors will ask you to fill out a questionnaire before your visit, but even if he or she doesn’t, “it’s a good practice to keep track of your sleep patterns and share that with your team,” says Jean Tsai, M.D., Ph.D., a sleep disorders specialist and an associate professor in the neurology department at the University of Colorado School of Medicine in Aurora.
In your sleep diary, you should record what time you go to bed, how often you wake up, how long you are awake in the night, and what time you get up in the morning. Additionally, make a note of anything unusual that occurs during the night, such as having especially vivid dreams or sleepwalking.
Looking for causes
If your doctor suspects that an underlying health condition is contributing to your sleep troubles, he or she may order blood tests in order to learn more. “Many illnesses, such as thyroid disease, for example, can contribute to sleep problems,” says Dr. Tsai.
“Insomnia due to a medical condition is most common in older adults because people tend to have more chronic health problems as they age,” notes Dr. Watson.
Chronic pain, no matter what your age or the reason for the pain, can also make it difficult to sleep. Fibromyalgia, arthritis, and other painful disorders are common sleep thieves as well.
Even when you share everything that’s going on with your health, a doctor will sometimes order a sleep lab study to learn more. As part of this overnight evaluation, doctors measure your oxygen levels, heart rate, blood pressure, brain activity, eye movements, and more while you sleep.